Drug side effect

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Drug side effect

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12 Posts

Oussama77
Forum Junior

Topics: 9
Posts: 58

08/28/08 - 02:03 PM

A 42-year-old woman comes to the physician for an annual pelvic examination and Pap smear. Over the past year, she has had increasing fatigue and difficulty sleeping. She has two children who both attend college. She is currently looking for part-time work outside the home. Her husband has been busy in a new start-up business. Examination shows no abnormalities. Laboratory studies show:

Hemoglobin 15 g/dL
Mean corpuscular volume 95 μm3
Leukocyte count 6000/mm3 with a normal differential
Serum
Na+ 145 mEq/L
Cl– 102 mEq/L
K+ 4.5 mEq/L
HCO3– 25 mEq/L
Urea nitrogen (BUN) 18 mg/dL
Creatinine 1.0 mg/dL
Alkaline phosphatase 70 U/L
Aspartate aminotransferase (AST, GOT) 22 U/L
Alanine aminotransferase (ALT, GPT) 19 U/L
γ-Glutamyltransferase (GGT) 83 U/L (N=5–50 U/L)

Which of the following is the most likely explanation for this patient's laboratory abnormalities?

A) Acetaminophen

B) Alcohol

C) Diphenhydramine

D) Estrogen effect

E) Ibuprofen

I have no idea, any suggestions ?

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Eagle_303
Forum Guru

Topics: 77
Posts: 655

08/28/08 - 02:56 PM

Alcohol intake

jmkhanzada
Forum Junior

Topics: 6
Posts: 82

08/28/08 - 04:50 PM

can u plz explain alcohol effect........thanx

Eagle_303
Forum Guru

Topics: 77
Posts: 655

08/28/08 - 05:28 PM

GGT is located in smooth endoplasmic reticulum the same location as CYP -450 .Any drug which induces the CYP-450 is likely to produce more GGT.

Chronic alcohol is the most common cause of this increase so my option will be with Alcohol.GGT is also used as an indirect biomarker for chronic alcoholism along with CDT.

Best of luck

Eagle_303
Forum Guru

Topics: 77
Posts: 655

08/28/08 - 05:59 PM

hero wrote:

But why ALT/AST is normal?
She has signs of cholestasis - increased alk. phosphatase and GGT.

My guess it's estrogen effect.

ALKALINE PHOSPHATASE (serum)

Normal range: 30-120 U/L (0.5-2 μkat/L [CF: 0.01667; SMI: 0.1 μkat/L])

Ref: Ferri's clinical advisor

Best of luck

kpmle2
Forum Guru

Topics: 95
Posts: 512

08/28/08 - 07:37 PM

What happens to MCV with alcohol?

This patient has Mean corpuscular volume of 95 μm3 .

Eagle_303
Forum Guru

Topics: 77
Posts: 655

08/28/08 - 08:20 PM

kpmle2 wrote:
What happens to MCV with alcohol?

This patient has Mean corpuscular volume of 95 μm3 .

The most sensitiv biomarker (in one sense because it is 0 - 100%) for Alcohol is "blood alcohol level" itself.None other other markers is 100% sensitive.

MCV has sensitivity of 34-89% only.

hero
Forum Guru

Topics: 42
Posts: 549

08/29/08 - 11:50 PM

so, what's the answer provided?

vanshita
Forum Guru
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Topics: 31
Posts: 933

09/04/08 - 06:45 AM

hitesh
.

Topics: 64
Posts: 1,075

09/04/08 - 10:07 AM

#10

There are no abnormalities in the labs except for increased MCV and GGT. Both point to Alcoholism.

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nightflight1945
banned

Topics: 32
Posts: 920

09/06/08 - 12:35 AM

#11

B) Alcohol

ngaybinhyen
Forum Guru

Topics: 23
Posts: 657

09/06/08 - 01:58 AM

#12

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